Medicare

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New Medicare Card – Transition begins April 1, 2018

Monday, December 18th, 2017

On April 1, 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBIs) to everyone with Medicare. The MBI will replace the Social Security Number (SSN)-based Health Insurance Claim Number for transactions like billing, eligibility status, and claim status after a transition period. You must be ready to accept the MBI beginning […]

Medicare Part B Secondary Payer Deductible Issues

Friday, August 19th, 2011

Medicare Part B claims processed after Friday, April 1, 2011, for which the beneficiary has a Medicare deductible remaining and Medicare is the secondary payer, are erroneously issuing payment despite the beneficiary’s deductible not being satisfied or despite the total Medicare Allowed Amount being applied towards the deductible. The recovery of overpayments made during this […]

Medicare physician payment may be reduced by a third

Thursday, December 9th, 2010

Providers can expect a reduction in Medicare payment of more than 30 percent in 2011 unless Congress grants a reprieve. In the Medicare physician fee schedule (MPFS) final rule that the Centers for Medicare and Medicaid Services has placed on display, providers paid under the MPFS are looking at a 2011 conversion factor of $25.5217, […]

CMS Offers Web-based Enrollment in 15 States and District of Columbia

Sunday, December 7th, 2008

Physicians in 15 states (Delaware, Minnesota, New Jersey, Idaho, Missouri, North Carolina, Illinois, Nebraska, Pennsylvania, Iowa, Maryland, Tennessee, Kansas, Michigan, Wisconsin and the District of Columbia) can now use CMS web-based system, PECOS ( Provider Enrollment, Chain and Ownership System)  site to Apply for Medicare enrollment online display and update current enrollment data check application […]

Ban on Faxed Prescriptions Deadline Moved

Wednesday, November 5th, 2008

Much to the relief of Medicare doctors who rely on computer-generated faxes to send prescriptions to pharmacies, the banning of faxed prescriptions deadline has been moved to Jan. 1, 2012.  Without this delay, those physicians would have to go back to paper-based prescriptions. However, Medicare physicians should focused on CMS’ new e-prescribing program which allows […]

Palmetto Requiring Complete Information on Providers To Update Any Changes

Tuesday, November 4th, 2008

We called in to Palmetto Provider Enrollment to follow up on an application sent in for one of our provider to change his correspondence address.  We were on hold for 2 hours and when we got thru, we were told that they needed a more completed application. When we asked why do we need to […]

More Palmetto GBA’s Bureaucracy

Monday, November 3rd, 2008

It is now 6 weeks into the transition and Palmetto’s Medicare CMS contract transition is still causing financial strain for thousands of clinics and providers.  So we thought it would be fun to track and share some of our own issues. Yes, Palmeto – you’re so special that we’ve created a whole section on our […]

California Cut Medicare Part B Premiums for Medi-Medi Patients

Friday, October 31st, 2008

Starting November 1, 2008, California will no longer pay for Medicare Part B Premiums for Medi-Medi Patients due to budget deficits. This only applies to Medi-Medi patients with a Medi-Cal share of cost exceeding $500. Beginning Saturday, as many people as 57,000 seniors and disabled people in California will see the $96.40 Medicare Part B […]

Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals

Wednesday, October 29th, 2008

If you do any Medicare billing or are interested in becoming a Medicare provider, then you must download the new 10th edition of Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals that just came out this month. The guide is very thorough and include: Introduction to the Medicare Program […]

Questions and answers on psychological and neuropsychological tests billed under CPT code range 96101-96125

Sunday, July 27th, 2008

1) Who is authorized by Medicare to bill for CPT code 96125 (that was added under CPT effective January 1, 2008)? CPT code 96125 ( standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional’s time, both face-to-face time administering tests to the patient and time interpreting these […]

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